Caregivers speak out against planned cuts to Medicaid payments, and the state Department of Public Health and Human Services responds.

"These are no doubt difficult times."

That’s Sheila Hogan, the head of Montana’s Department of Public Health and Human Services Thursday. She was kicking off a hearing on a planned cut to how much the department will pay doctors, hospitals and other health workers who take care of people on Medicaid.

The state has some regulatory authority over health plans sold to individuals and small groups, that’s about 114,000 people in Montana. That authority allows the state auditor to review, but not reject proposed prices by insurance companies.

One of the first graduates of the internal medicine residency program at Billings Clinic will join a practice in Sheridan, Wyoming this fall.

The residency program was created to increase the number of primary care physicians to serve patients who live in rural areas. The program was designed to train internists to care for complex medically ill patients in a rural environment, this includes working in a rural community. Each resident spends one month working at Central Montana Medical Center in Lewistown, Mont., and one month at Sheridan Memorial Hospital in Sheridan, Wyo.

Patients who are recovering from ailments like a stroke, spinal cord injury, or traumatic brain injury will soon be able to continue their rehabilitation care closer to home. Three health care entities announced yesterday they’re partnering to build and operate a rehabilitation hospital in Billings.